Doctor Name: | DEBORAH VAUGHAN |
NPI Number: | 1043410525 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 231137 |
Business Practice Address: | 1602 Lancaster Dr Suite 102 Grapevine, TX - 760513574 |
Business Phone Number: | 8173298364 |
Business Fax Number: | 8173291285 |
Mailing Address: | 1602 Lancaster Dr, Suite 102 GRAPEVINE |
State: | TX |
Postal Code: | 760513574 |
Phone Number: | 8173298364 |
Fax Number: | 8173291285 |
NPI Enumeration Date: | 07/23/2007 |
NPI Last Update Date: | 07/23/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 231137 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |